Bed‐sided short‐duration renal replacement therapy provide a possible option to treat non‐critical coronavirus disease 2019 in maintenance hemodialysis patients in public health crisis

Hu, Yanglin; Tu, Can; Dong, Jun‐Wu; Chen, Wen‐Li; Wang, Xiao‐Hui; Luo, Dan; Shi, Ming; Zhou, Mengliang; Song, Yuting; Zhang, Chun; Xiong, Fei

HD care may experience great stress with the coronavirus disease 2019 (COVID‐19) pandemic. A modified HD modality named bed‐sided short‐duration renal replacement therapy (BSRRT) was used in noncritical maintenance HD (MHD) patients diagnosed with COVID‐19 in Wuhan due to extreme situation. To determine the safety and efficacy as a substitution for intermittent HD (IHD), we conducted this study. We used the data of 88 noncritical COVID‐19 MHD patients collected from 65 medical units at the hospitals in Wuhan, China, from January 1 to March 10, 2020. t‐test, Wilcoxon rank sum test, and Fisher exact probability method were used to compare the baseline characteristics, treatment, and death. Log‐rank test and Cox regression multivariate analysis was used to compare the survival of noncritical patients who were transferred to BSRRT modality versus those who were continued on the IHD. Univariate analysis showed the level of reported fatigue symptom at present, bilateral lung computed tomography infiltration and steroid treatment differed between the two groups. The outcome of death of the two groups did not show significant differences in univariate analysis (P = .0563). Multivariate Cox regression analysis dialysis showed modality of treatment after COVID‐19 diagnosis was not a significant predictor of death (P = .1000). These data suggest that for noncritical COVID‐19 MHD patients, the transfer from IHD to BSRRT does not have significant difference in the risk of death compared with IHD group. This finding suggests this modified modality could be an option for the substitution for IHD during the COVID‐19 pandemic period.